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Prior DMARDs and Disease Duration in Patients With RA

The number of prior disease-modifying antirheumatic drugs (DMARDs) and disease duration affect responses to therapy in patients with established rheumatoid arthritis (RA), a new study found. Associations between disease duration or number of prior DMARDs and response to therapy were determined using data from 2 randomized controlled trials in patients with established RA receiving adalimumab plus methotrexate. Response to therapy was determined at week 24 using disease activity outcomes. Among the findings:

  • In the larger study (n=207), a greater number of prior DMARDs was associated with smaller improvements in DAS28(CRP), SDAI, and HAQ-DI from baseline to week 24.
  • RA duration of >10 years vs <1 year was associated with higher HAQ-DI scores at week 24, but results on DAS28(CRP) and SDAI were mixed.
  • A greater number of prior DMARDs and longer RA duration were associated with lower American College of Rheumatology (ACR) response rates at week 24.
  • Data from the smaller second trial (n=67) confirmed the findings.


Aletaha D, et al. Effect of disease duration and prior disease-modifying antirheumatic drug use on treatment outcomes in patients with rheumatoid arthritis. [Published online ahead of print August 21, 2019]. Ann Rheum Dis. doi: 10.1136/annrheumdis-2018-214918.